Stories about general surgery, trauma surgery, dumb patients, dumb doctors, and dumb shit from the dumb world around us.

Monday, 25 August 2014

Kids

Several of my patients are immediately confused when I introduce myself. Hi I'm Doctor Bastard, and I'll be your trauma surgeon today. What the hell is a trauma surgeon, they ask. That's like an ER doc, right?

I have to resist the urge to slap them.

After I'm finished explaining that I'm NOT an emergency physician, I describe to them that I fix soft squishy stuff - spleens, livers, intestines, stomachs, etc. I also have to explain that there are several things in trauma that I don't do -

bones - there is a reason why orthopaedic surgeons exist

brains - no one really understand how they work, least of all me

burns - burn centres exist for a reason too

kids

Believe it or not I actually strongly considered going into paediatrics when I was in medical school. On my short list . . . ok ok, you can stop laughing now. I'm serious. As I was saying, on my short list was paediatrics and surgery. I've always loved kids, so what could be better than helping them? This philosophy remained until one fateful day during my paediatrics clerkship in medical school. I was in the clinic seeing a 3-year old girl who had an earache. I was dressed in my perfectly pressed white coat, freshly-laundered white shirt, and a Winne-the-Pooh tie that Mrs. Bastard had given me for just this occasion. I walked into her examination room, got down on one knee, and said with a smile in my kindest, warmest voice, "Hi there. What's bothering you today?" The girl looked at me, turned to her mother, turned back to me, shut her eyes, opened her mouth, and let out the loudest, most blood-curdling scream I've ever heard.

At that very second my list immediately changed to this:

Paediatrics

Surgery

Even though my hospital isn't supposed to treat paediatric trauma (ambulances are supposed to take these patients to the local children's trauma hospital), every now and then they bring a little tyke to me for evaluation. And every single time it reminds me exactly why I didn't choose paediatrics.

Little Mary (not her real name) was clearly heard screaming way down the hall as she was wheeled towards my trauma bay. As soon as I saw her, I saw that her distress was fully justified - she had obvious scald burns over her chest, shoulders, back, and half her face. My first thought was "WHAT THE HELL HAPPENED TO THIS POOR GIRL??". My second thought was, "Wait, I don't do burns, and I don't do kids. I sure as hell don't do kids' burns!" Regardless, here she was being deposited on a gurney that appeared much too large for her. Mary's mother accompanied her, looking none-too-upset while she chatted to someone on her mobile phone about a household bill. A quick (but thorough) evaluation revealed an adorable 3-year old girl with second-degree burns over approximately 15% of her body, but thankfully no third-degree burns.

Mom was now talking on her phone about a post on Facebook. I turned to ask her a few questions about Mary's medical history. I actually had to stand in front of her, staring at her, for at least 30 seconds before she acknowledged my presence.

"Hang on a second, the doctor wants something."

'Wants something'? Yeah, I want to know what the hell happened.
Mary's mom told me that Mary was a healthy girl with no medical problems. When I asked her what happened, the story she told made me want to jump on her and tear her hair out.

"Well you see, I was cooking noodles on the stove, and I don't like to use the back burners because it's too far away when I have to stir. So anyway (yeah, hang on, I'm talking to the doctor) I walked out of the kitchen to check something on my phone, and I couldn't have been away for more than, like, a minute when I hear a crash and Mary screaming."

You read that right - Mary's mother left a boiling pot of water on the front of the stove, well within the reach of any curious 3-year old, and then she inexplicably walked away. TO CHECK HER FUCKING PHONE.

There were no words to say. I guess the incredulous look on my face made no impact, because mom went right back to her conversation about her hair appointment later that day, which she may have to call and postpone because of this.

We bandaged up Mary and gave her some pain medicine, and once she was comfortable we transferred her to the children's hospital for further care. I didn't think she would need any skin grafts, but burns have a tendency to deepen over the ensuing 24 hours after the injury, so only time would tell.

Mary's mom almost became my next trauma patient, because every nurse in the room nearly attacked her. I couldn't get her out of my trauma bay fast enough.

Nope, sorry...there is nothing more wrong with today's society than was wrong with yesterday's society or the day before yesterday's society and so on and so forth. The sad truth is there have always been a subset of the population that are horrible people and there always will be.

Thirty years ago my aunt was on the burn ward. In the bed next to her was a five year old kid who had been burned in an accident at home. My aunt was being kept in a medically induced coma, the kid was not and could have limited interaction with those around her. In the six weeks that my family held vigil over my aunt not once did the parents of that child visit. They didn't live far away, they didn't travel for work, they didn't have any obstacles to visiting her besides being so self-centered as to not care about their own child.

My family visited with her everyday. I was around the same age and couldn't visit, but I drew her pictures and cards and picked out some toys for her to have. I gave her my favorite books to read, my dad read her bedtime stories and tucked her in at night. My grandma and grandpa told her stories of their childhoods on the farms. One day my family came in and the girl's bed was empty, the nurses told them that the child had passed away. My family grieved for her as if she were one of our own.

She had been in the hospital nearly two months, terrified and in pain and her family had not once visited her...not even as she lay dying alone in a strange hospital bed surrounded by strangers in masks and gowns and the sights and sounds of the dead and dying. There have always been callous and horrible people...unfortunately this is nothing new!

You should have told the mother that you could tell that she needed immediate surgery for an infected gall appendix (make up something, anything that sounds official, clearly I know there's no such thing as a gall appendix!) and then immediately spay her.

I had that happen to me years ago when I worked in a pharm. The mother never got off her phone while I rang up the med for a 12 year old. Later the pharmacist told me he had to give the consult to the child as the mother wouldn't stop talking on her phone.

I thought that was bad but the mother in this story blows away the mother in my story.

And it doesn't occur to her that she did anything wrong or inappropriate that led to her child being injured. It's one thing to make a mistake (she walks away, the kid burns herself), but it is an entirely different matter to be INDIFFERENT to the mistake and the consequences. It's unfortunate that the daughter paid the consequences for the mother's lackadaisical attitude, and I fear for future incidents such as these. I'm against helicopter parenting, but all for *responsible* parenting.

I would imagine that her tune would be drastically different if SHE were the one that had been burned… or heaven forbid that she had dropped her phone in the boiling water.

I was also burnt by boiling hot water as a child. My mum was cooking pasta. She wanted to drain them when she saw me climbing onto our kitchen table. It looked like I was about to fall, so in order to catch me she dropped the pot and covered my left side with its content. Well, who knows what would've happened to me if I had fallen off that table.

About Me

I am a trauma and general surgeon at two hospitals in the suburbs of a major metropolitan area. One of the hospitals is in a rather poor suburb, the other is in a very affluent suburb. I see all kinds of crazy shit at both.
Feel free to email me at docbastard1@gmail.com if you have questions, comments, or stories you want me to publish. Yes, I'll give you credit.
Don't be afraid to comment or email me. I appreciate both!